{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NANCY H HALEY","gend":1,"add":"198 MASSANUTTEN VALLEY ROAD APT E6","city":"STANLEY","state":"VA","zip":"22851-9998","dob":"1946-11-10","age":"","mstatus":"","insh":"11009851","cliId":"","pno":5407782622,"cno":"","email":"","ename":"","eno":"","pphy":"LONG, KEITH C","ppno":5404773808,"pcpadd":"1661 S Main St","pcpcity":"Harrisonburg","pcpstate":"VA","pcpzip":228012728,"pcpcounty":"","pcpid":"","pcpname":"MOUNT JACKSON MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"198 MASSANUTTEN VALLEY ROAD APT E6","madd2":"","madd3":"","mcity":"STANLEY","mstate":"VA","mzip":"22851-9998","pcpfaxno":"(540) 713-4101","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","68180052002","LISINOP\/HCTZ ","20-25MG","30.00","Select","Select",""],["","62756014202","METFORMIN ","500MG ER","30.00","Select","Select",""],["","43547040211","FUROSEMIDE ","40MG","30.00","Select","Select",""],["","65162046650","IBUPROFEN ","800MG","90.00","Select","Select",""],["","00173071820","FLOVENT ","44MCG","10.60","Select","Select",""],["","00046087221","PREMARIN ","0.625MG","30.00","Select","Select",""],["","59310030240","QVAR ","40MCG","10.60","Select","Select",""],["","70710113908","FLUCONAZOLE ","150MG","5.00","Select","Select",""],["","24208063110","NEO\/POLY\/HC ","1% OTIC","10.00","Select","Select",""],["","00169406012","VICTOZA ","18MG\/3ML","6.00","Select","Select",""],["","50458014030","INVOKANA ","100MG","30.00","Select","Select",""],["","00378456105","POT  CHLORIDE","10MEQ ER","30.00","Select","Select",""],["","67877054360","CEFDINIR ","300MG","20.00","Select","Select",""],["","08470184001","UNFINE ","32GX4MM","90.00","Select","Select",""],["","51672128902","NYSTATIN ","100000","60.00","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}